Individual provider Active NPI

Khristina Crawford, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Memphis, TN
National Provider Identifier
1376129056
Registry record updated Jul 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
29390 Issued in TN
Practice address
1661 International Dr Ste 400
Memphis, TN 38120-1431
Phone
(901) 206-4495
NPI assigned
Mar 22, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatric/Mental Health Registered Nurse 163WP0807X 204910 TN
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 29390 TN Primary

Addresses

Primary practice location

1661 International Dr Ste 400
Memphis, TN 38120-1431

Mailing address

1661 International Dr Ste 400
Memphis, TN 38120-1431
Phone (901) 206-4495

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221014000481 TN Practitioner - Nurse Practitioner 4486020583 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
204910TNMDChild & Adolescent Psychiatric/Mental Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Alliance Healthcare Services CurrentSince May 28, 2022 Accepting new patients
Alliance Healthcare Services CurrentSince May 28, 2022 Accepting new patients

Locations

3200 Broad Ave
Memphis, TN 38112
Phone (901) 577-9400

2150 Whitney Ave
Memphis, TN 38127
Phone (901) 353-5440

2673 Yale Ave
Memphis, TN 38112
Phone (901) 262-4112

2220 Union Ave
Memphis, TN 38104
Phone (901) 369-1480

3810 Winchester Rd
Memphis, TN 38118
Phone (901) 369-1400

2579 Douglass Ave
Memphis, TN 38114
Phone (901) 369-1418

2100 Whitney Ave
Memphis, TN 38127
Phone (901) 353-5440

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1616371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1376129056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1661 INTERNATIONAL DR STE 400",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381201431",
            "telephone_number": "901-206-4495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1661 INTERNATIONAL DR STE 400",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381201431",
            "telephone_number": "901-206-4495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAWFORD",
        "first_name": "KHRISTINA",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-22",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0807X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Child & Adolescent",
            "state": "TN",
            "license": "204910",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "29390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.